HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Harisinghani, M. G. Articles by Mueller, P. R. Search for Related Content PubMed PubMed Citation Articles by Harisinghani, M. G. Articles by Mueller, P. R. Related Collections Vascular and/or Interventional Radiology Computed Tomography Genitourinary Radiology

CT-guided Transgluteal Drainage of Deep Pelvic Abscesses: Indications, Technique, Procedure-related Complications, and Clinical Outcome¹

¹ From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114. Recipient of a Certificate of Merit award for an education exhibit at the 2001 RSNA scientific assembly. Received February 28, 2002; revision requested April 5 and received June 5; accepted June 10. Address correspondence to M.G.H. (e-mail: mharisinghani@partners.org).

Deep pelvic abscesses may present a unique challenge for percutaneous drainage because of numerous overlying structures, which preclude safe percutaneous access. These structures include the pelvic bones, intestine, bladder, iliac vessels, and gynecologic organs. Use of the transgluteal approach to drain these abscesses can circumvent these obstacles and provide a useful surgical alternative or a temporizing measure. The transgluteal approach requires a thorough understanding of the anatomy of the sciatic foramen region and associated anatomic structures. The ideal approach for transgluteal access is to insert the catheter as close to the sacrum as possible, at the level of the sacrospinous ligament. Transgluteal drainage can be performed with the tandem-trocar technique or the Seldinger technique. Modifications of the procedure are needle aspiration not followed by catheter placement, use of the angled gantry technique, bilateral transgluteal drainage, combined anterior and posterior drainage, and drainage of necrotic pelvic masses. The transgluteal approach is a useful option in pediatric patients. Daily catheter care is essential for successful percutaneous catheter therapy. Although pain has been cited as a common complication of the technique, this complication can be minimized with judicious use of analgesia and a meticulous technique. Other complications are hemorrhage and catheter malposition.

© RSNA, 2002

Index Terms: Abscess, percutaneous drainage, 875.1263 • Computed tomography (CT), guidance • Pelvic organs, abscess, 875.211 • Pelvic organs, interventional procedures, 875.1263

This article has been cited by other articles:

				A. M. Cahill, K. M. Baskin, R. D. Kaye, C. R. Fitz, and R. B. Towbin Transgluteal Approach for Draining Pelvic Fluid Collections in Pediatric Patients Radiology, March 1, 2005; 234(3): 893 - 898. [Abstract] [Full Text] [PDF]

				J. K. H. Woo, S. F. Millward, and M. Harisinghani Transgluteal Approach for Percutaneous Drainage of Deep Pelvic Abscesses: How to Avoid Injury to Vital Structures * Dr Harisinghani responds: Radiology, October 1, 2004; 233(1): 300 - 302. [Full Text] [PDF]

				S. Gupta, H. L. Nguyen, F. A. Morello Jr, K. Ahrar, M. J. Wallace, D. C. Madoff, R. Murthy, and M. E. Hicks Various Approaches for CT-guided Percutaneous Biopsy of Deep Pelvic Lesions: Anatomic and Technical Considerations RadioGraphics, January 1, 2004; 24(1): 175 - 189. [Abstract] [Full Text] [PDF]

				E. Walser, S. Raza, A. Hernandez, O. Ozkan, M. Kathuria, and D. Akinci Sonographically Guided Transgluteal Drainage of Pelvic Abscesses Am. J. Roentgenol., August 1, 2003; 181(2): 498 - 500. [Full Text] [PDF]